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The bicuspid aortic valve (BAV) is the most common congenital cardiac malformation. Despite being a seemingly simple and harmless anatomic variation, BAV is said to cause more morbidity than any other congenital cardiac defect [52]. BAV may lead to aortic valve stenosis (AS) or regurgitation (AR), endocarditis, an ascending aortic aneurysm, and/or devastating dissection or rupture. Although these...
Pure aortic insufficiency (AI) represents 9.5% of the surgical indications of valve surgery in western countries [53, 92]. Dilation of the aortic root and/ or cusp prolapse are the most common causes of AI, characterized by pliable cusps that are macroscopically close to normal [29, 70]. Until recently, valve replacement was the only surgical option for AI. However, none of the current valve substitutes...
The aortic valve is a complex structure which functions perfectly in systole and diastole and under a wide range of hemodynamic conditions. Even today, no valve prosthesis can match the function of the native aortic valve. This is — at least partly — due to the fact that the aortic valve is not just an outlet whose cusps do move passively in the blood stream. Rather, the aortic valve — which consists...
The word “annuloplasty” derives from the Latin word anus or anulus meaning “ring” [1, 2] and the Greek word plastia from plastos meaning “molded” [3]. The official definition of “annuloplasty” is “surgical reconstruction of an incompetent cardiac valve” [1]. More generally, it means “plastic repair of a cardiac valve by shortening the circumference of its annulus” [2]. However, in practical surgical...
Aortic aneurysms grow not only in diameter but also in length. In the ascending aorta, such elongation may cause aortic valve incompetence in an otherwise normal valve by dislocation of the aortic valve plane towards the left ventricle and subsequent valve dislocation, causing leaflet prolapse. Loss of the sinotubular junction by aneurysmal widening of the aortic root may further add to this mechanism.
Aortic root operations involve the creation of fragile suture lines that become difficult to access once the repair is complete. Furthermore, these procedures involve working with aortic tissue that is extremely fragile, especially in patients with acute aortic dissection or connective tissue disorders. Consequently, securing hemostasis during these operations remains a significant challenge. In a...
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